The National Health Insurance (NHI) Act 20 of 2023 was enacted by the President on 15 May 2024.

The purpose of the Act is to establish the National Health Insurance Fund which will cover all citizens to allow for medical services which are free of charge and funded through mandatory pre-payments.  

The Act is not yet operational. It will come into effect, by proclamation, on a date to be determined by the President.

Notwithstanding the date of operation of the Act, the NHI system must be implemented on a phased basis and is set to become fully operational in 2028.

This legislation has been in the making for a lengthy period of time, starting with the NHI Green Paper (2011), followed by the NHI White Paper (2017), culminating in the NHI Bill which was adopted in Parliament’s National Assembly on 9 August 2019 and by the NCOP on 8 December 2023.